Document Detail

Utility of isoproterenol to provoke outflow tract gradients in patients with hypertrophic cardiomyopathy.
MedLine Citation:
PMID:  18312769     Owner:  NLM     Status:  MEDLINE    
It is important to identify patients with hypertrophic cardiomyopathy (HC) who have labile left ventricular outflow tract (LVOT) obstruction for consideration of ventricular septal reduction therapy. Although Doppler echocardiography has become the diagnostic modality to assess LVOT obstruction, it may not identify all patients with labile obstruction. This study assessed the diagnostic value of cardiac catheterization using isoproterenol challenge in 25 patients with HC in whom an LVOT obstruction (gradient >or=50 mm Hg) was clinically suspected, but not diagnosed using Doppler echocardiography. These patients underwent cardiac catheterization using a transseptal approach with isoproterenol challenge. During isoproterenol infusion, the gradient increased to >or=50 mm Hg in 14 patients and remained <50 mm Hg in 11 patients. Ten patients subsequently underwent surgical myectomy, 6 patients underwent alcohol septal ablation, and 9 patients were managed medically. Median follow-up was 26 months. Of patients who had a provoked gradient >50 mm Hg during isoproterenol infusion, 8 patients who underwent septal myectomy and 5 of 6 patients who underwent alcohol septal ablation had sustained alleviation of symptoms at follow-up. In conclusion, cardiac catheterization with isoproterenol challenge may identify patients with HC who may benefit from septal reduction therapy for whom the initial noninvasive evaluation does not show severe obstruction.
Ahmad Elesber; Rick A Nishimura; Charanjit S Rihal; Steve R Ommen; Hartzell V Schaff; David R Holmes
Related Documents :
11150629 - Troglitazone, an antidiabetic drug, improves left ventricular mass and diastolic functi...
10555459 - Sokolow-lyon voltage criteria in sickle cell patients.
3112859 - Left ventricular function in adults with atrial septal defect.
23868039 - Serum copper, zinc and selenium levels in tunisian patients with parkinson's disease.
10669669 - Left ventricular thrombus and subsequent thromboembolism in patients with severe systol...
19833379 - Bolus tenecteplase for right ventricle dysfunction in hemodynamically stable patients w...
22387429 - Wavelet analysis demonstrates no abnormality in contralateral suppression of otoacousti...
17390139 - Haemangiomas and vascular malformations of the limb in children.
23768819 - -592 and -1082 interleukin-10 polymorphisms in pulmonary tuberculosis with type 2 diabe...
Publication Detail:
Type:  Journal Article     Date:  2007-12-20
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-03-03     Completed Date:  2008-03-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  516-20     Citation Subset:  AIM; IM    
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Anti-Arrhythmia Agents / therapeutic use
Calcium Channel Blockers / therapeutic use
Cardiac Surgical Procedures
Cardiomyopathy, Hypertrophic / therapy*
Cardiotonic Agents / diagnostic use*
Disopyramide / therapeutic use
Ethanol / administration & dosage
Heart Catheterization
Heart Septum / surgery
Isoproterenol / diagnostic use*
Middle Aged
Retrospective Studies
Solvents / administration & dosage
Ventricular Outflow Obstruction / diagnosis*,  therapy
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Anti-Arrhythmia Agents; 0/Calcium Channel Blockers; 0/Cardiotonic Agents; 0/Solvents; 3737-09-5/Disopyramide; 64-17-5/Ethanol; 7683-59-2/Isoproterenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Factors influencing left ventricular structure and stress-corrected systolic function in men and wom...
Next Document:  Management of emergencies in adults with congenital cardiac disease.